Adherence: How People with HIV Manage Their Medications
Complex antiretroviral therapies, particularly regimens including protease inhibitors, offer the possibility of a healthier and longer life, but require extremely high levels of adherence to avoid emergence of resistance. This qualitative study uses focus group methodology to explore 1) factors that promote or interfere with adherence to antiretroviral therapy, 2) issues involved in deciding to initiate or postpone antiretroviral therapy, and 3) sources of information for decision-making about antiretroviral treatment initiation and management. A semi-structured investigator developed interview guide was used to elicit responses from 43 participants in six focus groups. Participants were predominantly male (93%), African-American (58%), and taking an average of 13 pills a day to treat their HIV. Efforts to enhance trustworthiness included broad-based sampling, audiotaping and field notes, summarization and validation of data at the end of each session, saturation of major themes, checks on coding process, and use of direct quotations. Analysis occurred at 2 levels: summarization of direct answers to questions and open coding to identify recurring themes. Motivation (e.g. staying alive for my children, symptom relief), factors impeding or facilitating adherence (e.g. denial, side effects, provider enthusiasm and support), and sources of information (e.g. pharmacists, Internet) about the regimens were identified. Major themes included decision-making, trust and confidence, attitudes and emotions, and a time dimension. Findings help clarify issues involved in decisions to initiate or delay antiretroviral therapy and will contribute to development of interventions to optimize medication adherence among people with HIV.
Learning Objectives: Articulate factors that promote or interfere with adherence to antiretroviral therapy, discuss issues involved in deciding to initiate or postpone antiretroviral therapy, and describe sources of information for decisionmaking about antiretroviral treatment initiation and management
Keywords: Adherence, HIV/AIDS
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.